I urge your support for all the motions on the Clár in the Health section and I commend the cumainn who put them forward.

It is often said that there is a two-tier health system in Ireland. Viewing Ireland as an island nation, as we most certainly do, there is, in fact, a three-tier system because in the Six Counties we have the NHS and in the 26 Counties we have the public-private system.

The NHS in the North is, of course, at the mercy of the Tory Government in London. In the 26 Counties we have suffered a succession of Health Ministers, each one worse than the last – Brian Cowen, Micheál Martin, Mary Harney and now James Reilly.

Mícheál Martin established the massive bureaucracy that is the HSE management structure. Mary Harney drove the privatisation of services and made the two-tier system even more inequitable and inefficient. And Brian Cowen as Finance Minister and as Taoiseach presided over economic collapse and made massive cutbacks to our public health services.

And now we have James Reilly. Where do I even begin?

Minister Reilly is famous for his facility with numbers. Who could forget his ‘logarithmical progression’ to explain the mysterious movement up the priority list of the primary care centres in his own constituency?

We have seen plenty of similar examples recently. For example, we have yet to solve the mystery of where Minister Reilly and his colleagues got the figure of €113 million for so-called ‘probity’ savings on medical cards in the Budget. That has since become €23 million of so-called ‘probity’ cuts in the HSE Service Plan but we all know what the bottom line is – medical cards are being taken off very ill children and adults and that is disgraceful.

We know too that the original HSE Service Plan memo to the Cabinet stated that it ‘will not be possible in 2014 to fully meet all of the growing demands placed on the health services’ but that this was changed to read that it will be ‘very challenging in 2014, to meet all of the growing demands’.

The first statement was correct and bears out all that we have been saying about the unsustainability of the year on year cutbacks imposed on our health services by this and the previous Governments.

The 2014 Service Plan brings to €4 billion the amount taken out of our health services since 2008. In terms of staff numbers, a further 2,600 whole time equivalents are to go in 2014, on top of the 12,500 that have gone since 2007.

The health funding plans of the Fine Gael/Labour Coalition have zero credibility. €666 million worth of spending cuts to health were signalled in the Budget. This became €619 million in the Service Plan. The Director General of the HSE has stated that the actual budgetary challenges facing the health service in 2014 is €1 billion.

The cuts introduced by the Irish Troika - Fianna Fáil, Labour and Fine Gael have devastated frontline care.Accident and emergency services in hospitals across the State are now under threat. Prescription charges have been trebled by Minister Reilly who so vehemently condemned them when he was in Opposition.

These cuts are unsustainable. Under the recently published HSE Divisional Plans hospitals are expected not only to function as last year but to perform better with a reduction of €200 million in their budgets. Already struggling acute hospitals face an average reduction of 4% in their funding. Front-line care, even by the HSE's own admission, is being affected, with a projected drop of 25,000 in the number of day cases and 3,000 in the number of in-patient treatments during 2014.

An example of how unrealistic these plans are is the target to reduce the delayed discharge of patients from acute hospitals by 4%. Yet the allocation for nursing home beds has been reduced, which will mean many more older people spending longer in scarce hospital beds because there are insufficient nursing home places for those requiring residential care.

We in Sinn Féin have a different vision – an all-Ireland public health service with access for all based on need and need alone, funded from fair and reformed general taxation and free at the point of delivery.

This Fine Gael/Labour Government has no intention of delivering anything remotely like that.

Their record on Health demands that this Fine Gael/Labour Government should go and go now.

And the first one out the door should be the Minister for Health James Reilly.